Reimbursement claim
Reimbursement claim
My reimbursement claim has been rejected for not submitting the original bill..I have inform them that I have misplaced the original bill that's why submitted with a duplicate bill but still they are
8 months ago
A. Dear Claim,
In case of misplaced or loss of the original document/bill, Insurer accepts the duplicate copy of the bill if it is certified by the bill issuing authority as certified to be true and processes the claim for reimbursement. You may escalate your grievance before the Grievance Redressal Officer of the Insurance Company for redressal of your grievance and if your claim is denied then you can file a complaint before the Consumer Court claiming the reimbursement and compensation for haras ...ReadMore
Insurance Broker Miscommunication: Need Help with Denied Treatment Coverage
An insurance broker confirmed to me via email that a treatment was covered, but after availing the treatment, the insurance company denied payment. Now the broker is not taking responsibility for thei
8 months ago
A. Dear Client,
Misleading information by an Insurance agent or broker is termed as professional misconduct under Regulation 21, Schedule - III of IRDA (Insurance Brokers) Regulations, 2002. So on repudiation of a claim by the Insurance Company, you may file a complaint against the Insurance Broker for professional misconduct to the concerned Insurance Company and IRDA for redressal of your grievance.
Jivan Bima ke sambandh mein
Sar Max insurance life mein meri ek policy hai jo ki mujhe pata nahin Thi 2015 Mein Mere father dwara Karai Gai Thi lekin iski Jankari Mujhko Kyon Nahin Di Gai usmein do kist Jama hai jo Bima company
8 months ago
A. Dear Client,
On default in payment of premium against the policy that stands automatically cancelled after a specific time or period as per the terms of the policy and the policyholder is not entitled to any refund from the said policy. You can renew the policy after paying the unpaid premiums if the Insurance company allows your appeal in terms of a policy condition. For further clarification, you need to visit the office of the Insurance 'Company.
THIRD PARTY INSURANCE
INSURANCE AMOUNT PAID TO FAKED PERSON WITH THE HELP OF LAWER
8 months ago
A. Dear Client,
If you are aware of the identity particulars of that fake person and supporting documents of payment of insurance premium to him then file a criminal suit for cheating u/s.420 IPC and for the involvement of the concerned Lawyer in said crime, make a complaint against him for professional misconduct to the concerned Bar Association and State Bar Council.
HEALTH INSURANCE PORTING - REJECTION OF CLAIM
The family health insurance policy taken from National Insurance Co. in the year 2005, renewed without any break, was ported to Manipal Signa in the year 2019. A claim was made in June 2023, but was r
8 months ago
A. Dear client,
send a legal notice to the Insurance Company and file a complaint u/s.35 of the CPA, 2019 against the Insurance Company Manipal Sigma for deficiency in service and unfair trade practise, requesting the total amount admissible under the policy as well as compensation for harassment and litigation costs. The complaint must be filed with the Consumer Court within two years after the date of the cause of action, i.e. the claim's rejection.
Can medical insurance be rejected
Can medical insurance be rejected for non disclosure of HIV but the patient died in hospital for brain stroke.
8 months ago
A. Dear Client,
Pre Existing Diseases (PED) are covered after completion of a lock-in period that varies depending upon the nature and category of diseases from 24 months to 48 months from the inception of the Health Insurance Policy that is renewed continuously for the lock-in period and thereafter. Insurers cannot refuse to sell you a plan or charge you more just because you have a pre-existing condition such as HIV, cancer, or even asthma. The few insurers provide coverage only to such persons ...ReadMore
Mediclaim policy - Husband has not mentioned his high bp
Husband has not mentioned his high bp during his mediclaim which he has made 2 yrs ago.Now he has had a knee surgery and is claiming an amount from the insurance company.Hospital documents have reveal
8 months ago
A. Dear Client,
Pre Existing Diseases (PED) are covered after completion of a lock-in period that varies depending upon the nature and category of diseases from 24 months to 48 months from the inception of the Health Insurance Policy that is renewed continuously for the lock-in period and thereafter. The authenticity and veracity of the hospital report need to be challenged first if the claim against knee surgery is repudiated on the ground of concealment of PED of high BP at the time of inception ...ReadMore
Bike Accident and Death
Hi Legal Expert, My Bike was met a accident with a drunken fellow and he died in hospital . On the time of accident Bike does not have any kind of insurance and its driven by some other person who ac
8 months ago
A. Dear client,
The owner of the vehicle, regardless of who was driving it at the time of accident, is liable to compensate the victim. The liability would shift on the insurance company if there was a third party insurance. Police will file the case in all cases where the victim dies.
Superdari Insurance
Vehicle has been released on Superdari, Can insurance be claimed fro vehicle repair before ending of proceedings from the insurance company?
9 months ago
A. Dear client,
Superdari Proceedings: Superdari is a legal term in India referring to the release of a vehicle or property seized by the police or other authorities during an ongoing investigation or legal proceedings. It allows the owner of the property to retain possession until the conclusion of the case. During Superdari proceedings, the ownership of the vehicle remains with the owner, and they are responsible for the vehicle's maintenance and repair.
Insurance Coverage: In the case of vehic ...ReadMore
Impact of LAMA discharge on Life insurance claim
Hi, My wife passed away last month. She was critically ill and was on death bed. I got her discharged under LAMA so that she could spent her last days with family. She got passed away after 2 days. Sh
9 months ago
A. Dear client,
In most cases, life insurance policies cover death due to natural causes, illness, or accidents, unless stated otherwise in the policy terms and conditions. If your wife's policy does not have any specific exclusions related to LAMA discharges, it is unlikely that the insurance company would reject the claim solely based on that reason. Insurance companies typically investigate claims thoroughly to ensure all necessary information is provided, and they may require documentation suc ...ReadMore
